Friday, September 25, 2009

Surprise Death

By Shawn Vuong

In the light of the current healthcare reform debates and all of the craziness that has come with it (the infamous 'death panel'), let us not forget what this debate is truly about, the patients.  

As Dr. Holm reminds us, eventually we will all come to our death.  The important thing is that we must let our loved ones pass away with a little dignity and pride.  To do this we must talk to our family members about their death wishes, as well as our own.  This is an important and often ignored piece of medicine that never gets the attention it deserves until it is too late.  

By Richard P. Holm MD

The late physician poet John Stone wrote of Death… I have seen come on/ slowly as rust/ sand/ or suddenly as when/ someone leaving/ a room/ finds the doorknob/ come loose in his hand.

This is not a topic about which anyone likes to talk.  The poignant truth, however, is that all of us will die one day, so we should go there every once in a while.  Many say they would like to die quickly and unexpectedly.  Let me go at ninety, shot by a jealous lover.  Or more realistically, let it happen in the night during sleep, after a joyful day, as a very old person, still with all my faculties.

As a physician, I have seen death occur in many ways.  Certainly, no one wants to die slowly while suffering, or after a long period without the capacity to know what is going on.  In these cases I have grown to appreciate the hospice attitude of comfort care, instead of medically trying to prolong an un-enjoyable life.  Perhaps our ability to keep someone alive has gone past our ethical understanding about how to know when to allow a natural death.

But here we are talking sudden death.  The kind of end that is unexpected.  When we lose someone and we have to say “Why?”

I have often wondered what the ghosts of those who die so abruptly must think.  Is it, “That wasn’t so bad!” or “Wow, that caught me off guard!” or “I wish I could have told my family one more time that I love them.” Or “That was a better way to go than that long and drawn out suffering way!”

I have had too much opportunity watching people hear and react to words like, “We have found cancer, and your condition is terminal.”  We are simply not built as human beings to handle the hopeless sound of a phrase like that.

It is better to live our lives with hope for a reasonable future, but still knowing that at any moment this could be our last.  One friend told me that when it’s his time to go, “Surprise me.”

Take home message:
   1. Talk to your family about your own death wishes;
   2. Finish your business and say what you should say everyday.

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